Open Maximal Mucosa-Sparing Functional Total Laryngectomy - HHM

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Thursday, 12 October 2017

Open Maximal Mucosa-Sparing Functional Total Laryngectomy

Authors: Pavel Dulguerov, Naif H. Alotaibi, Stephanie Lambert, Nicolas Dulguerov and Minerva Becker.

Background: Total laryngectomy after (chemo)radiotherapy is associated with a high incidence of fistula and therefore flaps are advocated. The description of a transoral robotic total laryngectomy prompted us to develop similar minimally invasive open approaches for functional total laryngectomy.

Methods: A retrospective study of consecutive unselected patients with a dysfunctional larynx after (chemo)radiation that underwent open maximal mucosal-sparing functional total laryngectomy (MMSTL) between 2014 and 2016 is presented. The surgical technique is described, and the complications and functional outcome are reviewed.

Results: The cohorts included 10 patients who underwent open MMSTL. No pedicled flap was used. Only one postoperative fistula was noted (10%). All patients resumed oral diet and experienced a functional tracheo-esophageal voice.

Conclusion: MMSTL could be used to perform functional total laryngectomy without a robot and with minimal incidence of complications.